Individual
MR. AUSTIN GLENN GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3046 E LAUREL ST, MESA, AZ 85213-2420
(209) 480-1516
Mailing address
3046 E LAUREL ST, MESA, AZ 85213-2420
(209) 480-1516
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/21/2016
Last updated
07/15/2016
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